The present invention relates to equipment with an incorporated cardiac radioreceiver (CRR) for temporary heart stimulation from the outside in case of open-heart operation, suitable to be left in situ to provide a permanent stimulation if subsequently necessary. The equipment is formed by an electrode with an epi-cardial stimulation tip, a cardiac radio-frequency receiver, and a quick jack-type connection emerging from said cardiac radio-frequency receiver and suitable for rapidly and easily connection to a permanent pacemaker.
As known, during open-heart surgical operations, the possibility of temporary artificial stimulation of the heart is always maintained; this is achieved by utilizing an electrode, the stimulation tip of which is temporarily fixed with a simple technique to the epimyocardium in a position corresponding to the left ventricle.
When the patient's thorax is closed, the free extremity of the electrode comes out through the thoracic wall and is connected to an external pacemaker.
After the prescribed period of rest and when artifical stimulation of the heart is no longer necessary, the electrode is extracted from the outside simply by pulling it. By doing so, whenever the patient's need for artificial stimulation becomes evident, it is necessary to perform another operation in order to implant a normal pacemaker.
The equipment described overcomes said drawback and offers more advantages.
According to the invention, the apparatus or equipment with an epi-cardial electrode is provided with an incorporated cardiac radio-frequency receiver for temporary stimulation in case of open-heart operation, and is provided with a device for connection to a permanent pacemaker.
After the necessary period of rest, the receiver is left permanently in situ.
Preferably, the device for connecting the electrode to a permanent pacemaker is essentially constituted of a quick jack-type connection, as described later. The equipment is implanted during the open-heart operation with the quick connection duly insulated, but the stimulating tip of the electrode is permanently fixed to the epimyocardium.
In this way the following objectives are attained:
a) The extremity of the electrode is not connected to an external pacemaker and does not cross the thoracic wall since the temporary stimulation is supplied, via the cardiac radio-frequency receiver, by an external radio-frequency transmitter (Personal pacemaker); since the extraction of the electrode is not required, risks of sepsis are avoided;
b) In the event of the patient needing artificial stimulation of the heart, subsequent to the prescribed period of rest, it is always possible to supply such stimulation in a timely way from the outside using the Personal pacemaker;
c) In the event of persistence of the need of artificial stimulation (indication of a need for a permanent pacemaker implantation) it is possible to implant a pacemaker with a simple superficial operation since only the pacemaker pocket has to be prepared; then the pacemaker can be connected to the cardiac radio-frequency receiver (CRR) using a stretch of electrode equipped with the plug for connecting it to the pin of the jack.
The advantages for the patient are:
Elimination of the electrode through the thoracic wall during the phase of temporary stimulation and reduction of the risks of sepsis.
Elimination of the always bothersome intervention of extracting the temporary electrode.
Possibility to maintain temporary stimulation from the outside for urgent needs.
Possibility to maintain temporary stimulation from the outside in case of urgent indication of need for permanent stimulation.
Great simplicity of the operation for the implantation of a permanent pacemaker when indicated.
Possibility to maintain the stimulation during the above-mentioned operation.
Possibility of periodic in-hospital checks of the pathological conditions of the patient (by means of the Personal pacemaker in the "laboratory" version).
Possibility of therapeutical interventions in the event the patient undergoes arrhythmic events; this therapy requires the use of the Personal pacemaker in the "antiarrhythmic" version that is capable to carry out the following antiarrhythmic programs: overdrive; underdrive; coupled stimulation; burst stimulation.
Great psychological support to the patient and his family since the Personal pacemaker is easily operated by non-specialized persons who have been given the necessary instructions.